Peak stress

[WOM]

So to recap: running own business, trusteeing charity, youth group volunteering, play-centre receptioning, full-time wife and mom, and a bit of gym working-out on the side. Stress, you say...?

[Antepli Ejderha]

This is absolutely excellent news, great to hear an update about you and your family. Look after yourself.

[Amor de Cosmos]

Great to see your name on the board again Balders and very reassuring news. When/if I ever get to Hitchin again we should do coffee.

[Femme Folle]

So happy to hear that things are going well for you and well done on the weight loss--that's no easy thing to do. I hope we see you around on here more often. x

[Gerontophile]

Good news and welcome back.

[Gangster Octopus]

This is good to read.

[E10 Rifle]

Welcome back Balders

[Balderdasha]

Great to see your name on the board again Balders and very reassuring news. When/if I ever get to Hitchin again we should do coffee.

I missed this at the time, but yes, do let me know if you're ever in Hitchin. Very happy to meet for coffee, might even manage it without a toddler in tow if he's at nursery.

[Amor de Cosmos]

I will certainly do that. It'll be towards the end of the year (at the earliest) but I'll make a note.

[Sits]

Always good to see you Balderdasha.

[Balderdasha]

Thanks! I rarely get the chance to post on here these days, but I am currently on holiday without my husband and children (worked out this is the first solo holiday I've taken in 9 years).

[hobbes]

I've never had a solo holiday.

[Balderdasha]

Yeah, I know not everyone does this. But I really like time by myself. It's not exactly alone time, because there are other people around to chat to and interact with, but it's independent time. After university, I moved 5,250 miles around the world on my own to a place where I knew no-one and barely spoke the language. So, for me, 9 years of always going on holiday as a family unit can feel quite restrictive.

[hobbes]

I'll bet, yes. I'm just not very good company for myself. I spent a few months alone all day every day between school drop off and pick up and I realised I'm a bad influence on me.

[WOM]

The idea of a solo holiday is appealing. The reality is that I'd be lonely and miserable in about two hours.

[Balderdasha]

I recently read back through this thread and realised I never properly answered someone's questions about my prognosis. At the time, I hadn't come to terms with my diagnosis and what it meant for the future.

So, I have had one severe episode of post-partum psychosis. This, in itself, is something that can be 100% recovered from, and for women who had no underlying mental health issues prior to PPP, it can be a one-off which is never repeated.

However, I did have underlying mental health issues. I had undiagnosed bipolar affective disorder. I had a type which is apparently quite common, where you present to the GP during your depressive periods, because they're awful and you feel like you want to die. What you don't do is present to the GP during your hypomania or mania phases, because those are fun, or when you get things done, or when you think you're awesome and are far too busy moving continent or getting drunk or booking in a million activities which you will later cancel during a depressive period. Because you only seek medical help during the depressive episodes you get diagnosed with depression. I was prescribed anti-depressants as a teenager, but never took them, I managed instead to find a centre that gave free counselling to under-25s and saw a fantastic counsellor for a year. When my daughter was one I was diagnosed with post-natal depression and given CBT and various group therapies.

Unfortunately, if you have bipolar, your risk of experiencing PPP goes up from a risk of one in a thousand for the general population, to a risk of 1 in 5 for each pregnancy. Now that I have had one episode, if I were to have another child my risk of having it again would be 50%. I consider that risk too high, and I consider myself very lucky to already have two healthy children, I will not be having any more.

So, what is the prognosis for bipolar? I've done quite a lot of research over the last couple of years. There is no cure. There are mood stabilisers that massively reduce your risk of a major relapse, either a severe depressive episode or a mania that tips into psychosis. The longer you go without an episode, the better your chances of avoiding another one is. Each episode damages your brain and makes more episodes likely. Very few people who have bipolar manage to go their whole lives with no more major episodes after diagnosis, but people do manage to remain well for stretches of 20-30 years.

As far as I am concerned, me having a major episode at any point in the next 20 years is not really an option. I have children to care for and they deserve me at my best. There are many things I can do to mitigate my condition and I attempt to do all of them. These are:

- take my medication. Co-operate with the psychiatrist and listen to medical advice. Over the next few months I may be attempting to switch from one mood stabiliser to another. The one I am on clearly works for me, but it has already knocked my thyroid out of whack and it carries a risk of knocking my liver or kidneys out, which are much harder to live without.
- sleep. I need 8 hours sleep a night, every night, so I go to bed religiously by 10pm when I know the children may be up at 6am (can push it slightly on holiday when I get a lie-in)
- exercise. Research shows exercise is particularly good for helping bipolar patients and anecdotally I find this to be true. I go to a minimum of 3-4 exercise classes a week, and walk an average of 26 miles Monday - Friday.
- no alcohol, no drugs. Very occasionally I have one, small drink with friends and that's it.
- minimal screen time, minimal time on social media. More time out of the house doing activities.
- I used to have a lot of bizarre repetitive coping mechanisms (obsessively playing boggle online, making thousands of identical interlocking origami boxes, reading books in bed for days on end and barely eating). I can't afford that level of avoidance any more and they send me into depressive spirals so I have knocked them all on the head and focus instead on addressing the stuff I am trying to avoid, ticking things off an endless to do list.

Psychosis is terrifying, I wouldn't wish it on my worst enemy, but if it happens again, at least I now know I have got through it once already.

[ursus arctos]

That's dead impressive, Balders.

What you've been through, what you've done, and the way you write about it.

[Nocturnal Submission]

It is indeed.

[diggedy derek]

A brilliant read.

[Balderdasha]

I feel at this point that I should clarify that a huge amount of this progress has been aided by my husband, who is my official carer. It is a very weird dynamic having your spouse become your carer, but he has been a carer in the best possible way. Instead of just doing things for me, what my husband does is observe my behaviour and then tell me whether what I'm doing seems to be helping or hindering my mental health.

If something is helping me, he will do whatever he can to support me to do more of it. So, if I need to go to the gym, want to go volunteering or meet friends, need time for self care like haircuts or doctor's appointments or getting my nails painted, or want to spend a week scything a meadow for example, he will be there looking after the children and doing anything necessary to make it possible for me to do. On the other hand, if I want to spend three days in bed adding LinkedIn contacts, or play several hundred games of online monopoly or 2048 in a row, or stay up past midnight watching crap TV (I wish these were not real recent examples), he absolutely will not support me in my ambitions, and gets quite annoyed with me because he's the one who has to deal with the fall out of not looking after my mental health. I am doing so much better largely because he doesn't baby me, he just steers me towards doing more of what helps me and less of what hurts.

It's hard trying to be so sensible all of the time. Coming to terms with my diagnosis has meant reassessing my past and acknowledging my past behaviours that I enjoyed but were not necessarily healthy and are no longer sustainable as a parent. I definitely used to enjoy my hypomania phases and seek out thrills. I think I actively curated a life of entertaining pub anecdotes, and didn't realise it was extreme. But not many people have episodes where they find themselves drunkenly standing on top of a car in a small Chinese city, or let homeless people sleep on their sofa, or get arrested for climbing in the Fontana di Trevi and crash a motorbike in the same holiday, or respond to a break up by renting their lounge to a trapeze artist and climbing Annapurna. I can see now that lots of this was extreme behaviour, at the time it was just fun.

What was not fun were the depressive episodes. I have wasted so much of my life in despair and avoidance cycles. Feeling bad, so doing something obsessive to avoid thinking about it and shutting myself off from the world, which makes the despair even worse, so more avoidance strategies until it gets worse and worse. My only saving grace was that for me these depression periods were rarely combined with substance abuse as is the case for many people who have bipolar. I used to drink heavily, and smoked weed a lot in my twenties, but not usually when alone and never dabbled in anything further (I used to watch people on drugs, and observe that I could get most of those effects while not on drugs so what was the point? Again, now I realise most people cannot go sober clubbing until 7am when they're in a hypomania phase, or trigger hallucinations at will).

One of the hardest parts of my diagnosis is that my family, my parents and sister, are in denial about it. They know I had PPP but believe it was triggered purely by an incident with my husband (it was partly) and refuse to believe that I had underlying bipolar. They consider him to be very controlling because of how he supports certain behaviours and not others. In fact, I haven't spoken to my sister in nearly a year, since she responded to us having an argument over the phone (I told her my husband wasn't abusive, then responded to the tirade that followed by saying I refused to have a massive argument in the middle of LIDL in front of my daughter and I was going to hang up) by phoning social services and telling them she thought I was in the middle of a manic episode and was unsafe to look after my children. My sister simultaneously believes I do not have bipolar, but thinks that if I disagree with her I'm having a manic episode, it's quite hard to wrap my head around. This was the day before my gall bladder operation, so social services ending up ringing me and grilling me straight after I arrived home and was still in the 24 hour post-anaesthetic period when you're not meant to drive or sign any legal documents. Cutting off my sister has been fairly straightforward, but the killer is that it also cuts my nieces out of my life, who I adore and helped raise.

[Sporting]

Not to trivialise things, I hope, but I would say that letting homeless people sleep on your sofa is commendable, not extreme.

Much more seriously, I echo all those in thanking you for sharing all this with us,

[Antepli Ejderha]

Thanks for sharing this Balders, it's really helped me see things and people in a different light. Have you thought about helping others? It really sounds as if you've come out the other side as an extremely knowledgeable human being with skills to cope with many things life throws at us all.

[laverte]

It is a very weird dynamic having your spouse become your carer

Agreed. My spouse is my primary carer, at one point was my only carer. My case is a bit different as my disability is fundamentally physical, although it affects every aspect of my being. i started to worry about becoming overly dependent on her, at the same time as feeling the inevitable guilt about eating into her life, so we now pay for a second carer for me, who visits infrequently but regularly. This has been a great relief, the full-on intensity of our relationship has eased enough that there is now room for light and shade, and the mere fact that someone else visits the flat every week has made it feel less cramped. It seems as though you see plenty of other people and have activities outside the home, which is important because even though the dynamic sounds like it works brilliantly, you are unavoidably investing more in your relationship than most other couples have to. i too had to cut contact with my family and without that safety net i have become extra conscious of the need to maintain relationships outside of my couple for the benefit of my own long-term health.

It's hard trying to be so sensible all of the time.

Agreed again. Outside of the pain and the discomfort and the dependence and the fear and the hoops i have to jump through with the medical bureaucracy, among the worst things about being ill is that it has made me even more boring than i would otherwise have been in middle age. My regimen has bizarrely become a kind of comfort blanket, to the extent that i can't even lie in any more, let alone have a glass of wine, without fearing that i'll send everything crashing again.

Good luck to you with your treatment and regime, and i hope it allows you the freedom to continue to be fabulous and inspiring (and to tell this forum about it when you have the chance)!

[ursus arctos]

That the two of you manage to be among the single most thought-provoking and inspiring posters on this board notwithstanding the travails you regularly endure is nothing short of amazing, and I feel privileged to be part of the audience.

Thank you. Be well. This place is much the richer for your participation.

[laverte]

That's a lovely thing to write. Thank you.